DHA Clinical Dietitian exam questions

6 worked Clinical Dietitian practice questions

Original exam-style questions from the bank, spread across the blueprint domains. They are not real or recalled exam questions. Try each one, then open the answer for the rationale and reference. None of them appear in the free mock exam, so reading them will not spoil it.

1. Question 1 · Enteral and Parenteral Nutrition

   A patient with BMI 15 kg/m2 and negligible intake for 12 days is to start nutrition support. Which starting plan is recommended?

   1. A35 kcal/kg/day with phosphate check weekly
   2. BFull requirements from day 1
   3. CMaximum 10 kcal/kg/day with thiamine first
   4. DDelay feeding until electrolytes rise
   Show answer and explanation

   Correct answer: C. Maximum 10 kcal/kg/day with thiamine first

   This patient is at high refeeding risk, so feeding starts at no more than 10 kcal/kg/day with thiamine and B vitamins beforehand, increasing slowly while monitoring and replacing phosphate, potassium and magnesium. Delaying feeding worsens malnutrition.

   Reference: NICE CG32 Nutrition Support for Adults

2. Question 2 · Food Service Management and Food Safety

   Within which temperature range do food-borne bacteria multiply most rapidly?

   1. A5 to 60 degrees Celsius
   2. BBelow 0 degrees Celsius
   3. C60 to 100 degrees Celsius
   4. DBelow 5 degrees Celsius only
   Show answer and explanation

   Correct answer: A. 5 to 60 degrees Celsius

   The danger zone is roughly 5 to 60 degrees Celsius, so hot food should be kept above 60 degrees and cold food below 5 degrees. Freezing stops growth but does not kill most bacteria.

   Reference: WHO Five Keys to Safer Food Manual

3. Question 3 · Life Cycle and Paediatric Nutrition

   A mother asks how long she should exclusively breastfeed her healthy term baby. What does WHO recommend?

   1. ATwelve months
   2. BTwo months
   3. CFour months
   4. DSix months
   Show answer and explanation

   Correct answer: D. Six months

   WHO recommends exclusive breastfeeding for the first 6 months, then nutritionally adequate complementary foods with continued breastfeeding up to 2 years or beyond.

   Reference: WHO Infant and Young Child Feeding Fact Sheet

4. Question 4 · Medical Nutrition Therapy: Diabetes, Cardiometabolic and Obesity

   A patient with type 2 diabetes on a sulfonylurea chooses to fast during Ramadan after counselling. At what self-monitored glucose level should she be advised to break her fast?

   1. ABelow 6.1 mmol/L (110 mg/dL)
   2. BBelow 5.6 mmol/L (100 mg/dL)
   3. CBelow 3.9 mmol/L (70 mg/dL)
   4. DOnly if she loses consciousness
   Show answer and explanation

   Correct answer: C. Below 3.9 mmol/L (70 mg/dL)

   Patients should break the fast if glucose falls below 3.9 mmol/L (70 mg/dL) or rises above 16.7 mmol/L (300 mg/dL), or if symptoms occur. Waiting for loss of consciousness is dangerous, and higher thresholds would make fasting needlessly impossible.

   Reference: IDF-DAR Diabetes and Ramadan Practical Guidelines 2021

5. Question 5 · Medical Nutrition Therapy: Renal, Hepatic and Gastrointestinal

   A metabolically stable 60-year-old without diabetes has CKD stage 4 and is not on dialysis. Which protein intake is recommended to slow progression?

   1. A1.0 to 1.2 g/kg/day
   2. B0.55 to 0.6 g/kg/day
   3. C1.5 to 2.0 g/kg/day
   4. D0.2 g/kg/day without supplements
   Show answer and explanation

   Correct answer: B. 0.55 to 0.6 g/kg/day

   KDOQI 2020 recommends a low-protein diet of 0.55 to 0.6 g/kg/day, or a very low-protein diet with keto-acid analogues, under close supervision. 1.0 to 1.2 g/kg/day is the target once on maintenance dialysis.

   Reference: KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update

6. Question 6 · Medical Nutrition Therapy: Renal, Hepatic and Gastrointestinal

   A man with cirrhosis has recovered from an episode of hepatic encephalopathy. His family asks whether he should restrict protein. What is the recommended advice?

   1. ARestrict protein only during the day
   2. BRestrict protein to 0.5 g/kg/day
   3. CAvoid all animal and plant protein
   4. DDo not restrict; aim for 1.2 to 1.5 g/kg/day
   Show answer and explanation

   Correct answer: D. Do not restrict; aim for 1.2 to 1.5 g/kg/day

   Protein restriction worsens muscle loss and is not recommended; ESPEN advises 1.2 to 1.5 g/kg/day with small frequent meals and a late evening snack. Restriction may only be considered very briefly in severe acute episodes.

   Reference: ESPEN Guideline on Clinical Nutrition in Liver Disease 2019